Hospital-Acquired Conditions (HACs)
Hospital-Acquired Conditions (HACs) are reasonably preventable complications that develop during a hospital stay, such as pressure ulcers, falls, or certain infections; payers may deny additional payment for treating them, tying patient safety directly to reimbursement.
What are Hospital-Acquired Conditions (HACs)?
Hospital-Acquired Conditions (HACs) are complications that a patient develops during a hospital stay and that are considered reasonably preventable through accepted care practices. Common examples include certain surgical site infections, pressure ulcers, catheter-associated urinary tract infections, falls with injury, and objects accidentally left in the body after surgery.
Because these conditions were not present when the patient was admitted, payers may decline to provide the additional reimbursement that treating them would otherwise generate. In effect, the cost of the avoidable complication shifts to the facility.
Why do Hospital-Acquired Conditions matter for the revenue cycle?
HACs link patient safety directly to payment, which makes accurate present-on-admission documentation essential. If a condition truly existed before the encounter but is not recorded as such, a facility can lose legitimate reimbursement, so coding and clinical documentation teams play a central role.
For surgery centers and the revenue-cycle teams supporting them, the lesson is that complications affect both clinical reputation and the bottom line. Preventing infections and procedural errors protects margins as much as it protects patients.
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